Michael K. Miller

A Complete Data Set of Political Regimes, 1800–2007:

This article updates and describes a widely used data set on democracy. Covering 1800–2007 and 219 countries, it represents the most comprehensive dichotomous measure of democracy currently available. We argue that our measure’s distinguishing features—a concrete, dichotomous coding and a long time span—are of critical value to empirical work on democracy. Inspired by Robert Dahl, we define a country as democratic if it satisfies conditions for both contestation and participation. Specifically, democracies feature political leaders chosen through free and fair elections and satisfy a threshold value of suffrage. After comparing our coding to that of other popular measures, we illustrate how democracy’s predictive factors have evolved since 1800. In particular, we show that economic modernization variables have steadily declined in their correlation with democracy over time.

Methods for distance-based judgment aggregation

Judgment aggregation theory, which concerns the translation of individual judgments on logical propositions into consistent group judgments, has shown that group consistency generally cannot be guaranteed if each proposition is treated independently from the others. Developing the right method of abandoning independence is thus a high-priority goal. However, little work has been done in this area outside of a few simple approaches. To fill the gap, we compare four methods based on distance metrics between judgment sets. The methods generalize the premise-based and sequential priority approaches to judgment aggregation, as well as distance-based preference aggregation. They each guarantee group consistency and implement a range of distinct functions with different properties, broadening the available tools for social choice. A central result is that only one of these methods (not previously considered in the literature) satisfies three attractive properties for all reasonable metrics.

Does Glycemic Variability Impact Mood and Quality of Life

BACKGROUNDnDiabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied.nnnMETHODSnA descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72u2009h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as energy, and (3) mood (depression, anxiety, anger) and quality of life by questionnaires.nnnRESULTSnWomen with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions.nnnCONCLUSIONSnData suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.

Elections, Information, and Policy Responsiveness in Autocratic Regimes:

The responsiveness of policy to election results is a central component of democracy. Do the outcomes of autocratic elections also affect policy choice? Even when the threat of turnover is low, I argue that autocratic elections influence policy by allowing citizens to signal dissatisfaction with the regime. Supplementing existing work, this study explains how this opposition is communicated credibly and then shows that ruling parties use this information to calibrate policy concessions. In the first cross-country analysis of autocratic election outcomes and policy choice, I find that negative electoral shocks to ruling parties predict increases in education and social welfare spending and decreases in military spending following elections. In contrast, there is no policy effect leading up to elections, in response to violent contestation, or in resource-rich regimes, illustrating a potential mechanism for the resource curse.

Democratic Pieces: Autocratic Elections and Democratic Development since 1815

This article overviews the history of autocratic elections since 1815 and then tests how a countrys experience with autocratic elections influences both democratization and democratic survival. To comprehensively capture this history, the study employs original measures of Robert Dahls electoral dimensions of contestation and participation. First, it shows that autocratic elections have been common for centuries, but that their character has changed dramatically over time. Whereas high contestation almost always preceded high participation prior to 1940, the opposite occurs in modern regimes. Secondly, it demonstrates that a countrys history of contestation predicts both democratization and democratic survival, whereas participation is positive for survival but generally negative for democratization. Thus, democracies are more likely to survive if they experience autocratic elections prior to democratizing, which has implications for democracy promotion and future political development.

Electoral Authoritarianism and Human Development

Do autocratic institutions matter for the welfare of average citizens? Despite the large literature comparing democracies and autocracies, we know little about how human development outcomes differ among autocratic types. Contrary to conventional wisdom, this article argues that contested autocratic elections promote human development by improving state accountability and capacity. Using an instrumental variables setup, I show that the presence and history of multiparty autocratic elections predict significantly better outcomes on health, education, gender equality, and basic freedoms relative to non-electoral autocracy. In fact, the effects on health and education are as strong as the effects of democracy. In contrast, legislatures and parties without multiparty elections produce slightly negative outcomes because these institutions chiefly concern elite cooptation. The results have major implications for the study of autocracy, the political economy of development, and the welfare effects of international election promotion.

Patterns of Substance Abuse among Rural Black Adolescents

Adolescent substance abuse continues to be a major health-related problem in this country. Although substantial information is available on the overall incidence of use, comparatively little attention has been given to use patterns among minority adolescents or those who reside in nonmetropolitan areas. Using data from the most recent Monitoring the Future survey, we examine the role of race and residence in affecting substance abuse patterns. Overall, our findings are consistent with previously reported research in indicating that residence differences are modest. Additionally, compared with Whites, Black youth are much less likely to report drug use. In the bivariate analysis, major correlates of use include gender, family structure, religious attendance, grade point average (GPA), and the availability of unearned income. In the multivariate analysis, race, family structure, religious attendance, GPA, and unearned income remain significant. The potential protective role played by family and church in the rural, Black context is discussed.

NEWTON: Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity After Subarachnoid Hemorrhage

BackgroundAneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality. EG-1962 is a sustained-release microparticle formulation of nimodipine that has shown preclinical efficacy when administered intraventricularly or intracisternally to dogs with SAH, without evidence of toxicity at doses in the anticipated therapeutic range. Thus, we propose to administer EG-1962 to humans in order to assess safety and tolerability and determine a dose to investigate efficacy in subsequent clinical studies.MethodsWe describe a Phase 1/2a multicenter, controlled, randomized, open-label, dose escalation study to determine the maximum tolerated dose (MTD) and assess the safety and tolerability of EG-1962 in patients with aSAH. The study will comprise two parts: a dose escalation period (Partxa01) to determine the MTD of EG-1962 and a treatment period (Partxa02) to assess the safety and tolerability of the selected dose of EG-1962. Patients with a ruptured saccular aneurysm treated by neurosurgical clipping or endovascular coiling will be considered for enrollment. Patients will be randomized to receive either EG-1962 (study drug: nimodipine microparticles) or oral nimodipine in the approved dose regimen (active control) within 60xa0h of aSAH.ResultsPrimary objectives are to determine the MTD and the safety and tolerability of the selected dose of intraventricular EG-1962 as compared to enteral nimodipine. The secondary objective is to determine release and distribution by measuring plasma and CSF concentrations of nimodipine. Exploratory objectives are to determine the incidence of delayed cerebral infarction on computed tomography, clinical features of delayed cerebral ischemia, angiographic vasospasm, and incidence of rescue therapy and clinical outcome. Clinical outcome will be determined at 90xa0days after aSAH using the extended Glasgow outcome scale, modified Rankin scale, Montreal cognitive assessment, telephone interview of cognitive status, and Barthel index.ConclusionHere, we describe a Phase 1/2a multicenter, controlled, randomized, open-label, dose escalation study to determine the MTD and assess the safety and tolerability of EG-1962 in patients with aSAH.

Use of Fourier Models for Analysis and Interpretation of Continuous Glucose Monitoring Glucose Profiles

Background: The introduction of continuous glucose monitoring (CGM) devices has dramatically increased the amount of information available about each patient. While CGM has become a useful diagnostic tool for the individual patient, interpretive issues including noise reduction remain and further analytical work is needed to fully utilize the data richness. Method: We applied discrete Fourier transform methodology to CGM data to obtain an overall statistical model providing the dimension reduction necessary for insightful analyses of the whole function and explored some properties and possible applications of this technology. Results: The following example applications are shown. Discrete Fourier transform allows reduction of noise using an objective statistical criterion and may, as a first step, possibly enhance the value of various measures of variability through this noise reduction. Average functions of groups in a prospective randomized clinical are demonstrated and the aggregate function is readily visualized. Second and third harmonic amplitudes at baseline correlate with hemoglobin A1c after a 6-month treatment period. The time points of most rapid glucose decreases are identified easily with the functional through the second derivative, and its correlation with subsequent reported symptomatic hypoglycemia is shown. Conclusions: Discrete Fourier transform offers an attractive analytical methodology for CGM data given the achievable dimension reduction without loss of essential information as well as its ability to eliminate noise.

Comparison Pharmacokinetics of Two Concentrations (0.7% and 1.0%) of Nasulin™, an Ultra-Rapid-Acting Intranasal Insulin Formulation

Background: This pharmacokinetic (PK) study was designed to characterize the dose response of two concentrations (0.7% and 1%) of a nasal spray of recombinant regular human insulin in combination with cyclopentadecalactone (CPE-215), a compound that enhances absorption of molecules across mucous membranes (Nasulin™, CPEX Pharmaceuticals). Nasulin has been effective in lowering blood glucose in both normal subjects and diabetes patients, and additional dosing options would allow greater titration flexibility. Method: A five-period crossover study of 24 healthy, nonsmoking subjects (ages 18–50, basal metabolic index <33 kg/m2, weight >70 kg) were studied. Subjects were in a fasted state for 5 h before and 45 min after administration for PK assessment and were then given a meal. Each spray contained 100 μl. Doses tested were 25, 35, 50, 70, and 100 U. Maximum concentration (Cmax) and area under the curve (AUC) were estimated for each dose group. Glucose measurements were also performed. Results: A dose response (slope of the natural log response versus dose) was demonstrated by baseline-adjusted Cmax of 22, 27, 56, 62, and 84 μU/ml for the 25, 35, 50, 70, and 100 U doses (p < .0001), respectively, and by baseline-adjusted AUC(0–45 min) values of 491, 592, 1231, 1310, and 1894 μU/ml/min (p < .0001). Glucose AUC(0–45 min) determinations also demonstrated a pharmacodynamic (PD) dose response. Conclusions: Proportional and linear dose responses for both PK and PD parameters were demonstrated for the two concentrations, making multiple doses available for clinical development.